Metabolic syndrome -- Khunti and Davies 331 (7526): 1153 -- BMJ

Metabolic syndrome -- Khunti and Davies 331 (7526): 1153 -- BMJ
Independently raises cardiovascular risk and should be picked up in primary care


Metabolic syndrome is characterised by hyper-insulinaemia, low glucose tolerance, dyslipidaemia, hypertension, and obesity. This cluster of factors has been recognised for many years, but the syndrome was not formally labelled until Reaven did so in 1988 and suggested that insulin resistance was its central characteristic.1 Insulin resistance seems to be the main underlying factor leading to the increased risk of mortality from coronary heart disease among people with the syndrome.2 Strategies to combat the forecast epidemic of type 2 diabetes and its vascular complications should focus on preventing and intervening early in metabolic syndrome./.../

It is becoming increasingly clear that a proinflammatory state is a common feature of the syndrome and of atheromatous disease. A recent randomised controlled trial showed that insulin resistance and measurements of C reactive protein were significantly lower at two year follow-up in patients with metabolic syndrome who had been allocated to a Mediterranean diet than in those who continued their normal diets.12 Although large intervention studies have shown that intensive modification of lifestyle delays the onset of diabetes in patients with impaired glucose tolerance,w9 no similar trials have aimed at reducing all the cardiovascular disease risk factors among people with metabolic syndrome.